Arteriogenesis

The term arteriogenesis is the emergence of a natural bypass after a vascular occlusion (stenosis ), for example, in the heart or in the leg ( peripheral vascular ) in humans, but also in the experimental animal model, respectively. Here grow ( proliferate ) very small blood vessels ( arterioles) to very much larger blood vessels ( arteries).

Mechanism of arteriogenesis

The process is made possible by dilation of the vessel lumen, the addition of myocytes (smooth muscle cells) and hypertrophy of the vascular endothelium. The trigger for arteriogenesis is a stenosis of a vessel supplying blood. The decreased perfusion pressure, but mainly shear forces ( shear stress ) in the remaining blood vessels causes an activation of the endothelium. The latter in turn leads to an inflammatory response to the release of nitric oxide, and transcription factors such as HIF- 1α (hypoxia -induced factor) and ultimately a release of cytokines such as MCP -1 ( Monocyte Chemotactic Protein -1). In monocytes and macrophages essentially - - Furthermore, activation of inflammatory cells and increased expression of adhesion molecules ( Intracellular Adhesion Molecule -1, ICAM -1) induced.

When arteriogenesis the vessel diameter can be increased to 20 times the initial diameter. In most cases, an adequate blood supply is enabled again so.

In medical research is tried to stimulate arteriogenesis by certain substances, such as granulocyte-macrophage colony stimulating factor (GM- CSF). This should be available in the future, new therapies for the treatment of cardiovascular diseases.

Differentiation for angiogenesis

In contrast to angiogenesis, arteriogenesis is independent of an oxygen supply (hypoxia).